All in your head?

A primer on the four most common headaches.

By Lauren Ferranti-Ballem

All in your head?

If you consider headache pain an inevitable part of a hectic lifestyle, you're doing yourself a disservice. Most headaches are treatable with over-the-counter (OTC) medications. The trick is knowing what type of headache you have so you can find the best possible solution. The bottom line? You don't have to live with the pain. Developed with the help of Dr. Ralph Kern, a consultant neurologist at the Wasser Pain Management Centre at Mount Sinai Hospital in Toronto, our guide will help you nail down a name and treatment for your noggin-splitting episodes.

1. MIGRAINE HEADACHE

IDENTIFY IT
Throbbing, disabling pain often on one side of the head but also around the eyes or at the back of the head. Usually accompanied by light and sound sensitivity and nausea. Lasts from four to 48 hours.

INVESTIGATE IT
Triggers include stress, lack of sleep and changes in barometric pressure. It's believed the chemical tyramine - found in red wine, chocolate and cheese - can induce headaches. Migraines are three times more common in women, often occurring with fluctuating estrogen levels.

TREAT IT
Mild cases may respond to OTC medications such as acetylsalicylic acid (ASA), ibuprofen (Advil, Motrin) and acetaminophen (Tylenol). For severe attacks, Kern recommends triptans - prescription drugs designed for migraine pain that stop the pain and inflammation of blood vessels during this type of headache.

2. TENSION OR MUSCLE CONTRACTION HEADACHE

IDENTIFY IT
Mild to moderate pressure caused by excessive tightening of muscles beneath the scalp (it feels as if a tight band is wrapped around your head). Typically lasts a few hours but can drag on as long as a migraine (though pain is not as severe).

INVESTIGATE IT
Triggers include stress, depression, irregular sleep patterns and poor posture.

TREAT IT
In most cases, OTC painkillers such as ASA, ibuprofen and acetaminophen will do the trick. Severe or chronic cases may require doctor-prescribed painkillers.

3. CLUSTER HEADACHE

IDENTIFY IT
Disabling ache usually located around one eye that often causes eye redness, tearing, swelling and nasal congestion on the affected side. Attacks last from 15 minutes to three hours and fall into recurring cycles (or clusters) over weeks or months.

INVESTIGATE IT
Those who are sensitive to alcohol, beware - even an ounce can cause clusters in some people, says Kern. Keeping a headache diary may help identify triggers, including food and sleep patterns.

TREAT IT
Since it can occur suddenly and pass quickly, OTCs usually aren't fast enough. Inhaling oxygen can stop an attack and may be an option for chronic sufferers. Speak to your doctor about a prescription.

4. CERVICOGENIC OR NECK HEADACHE

IDENTIFY IT
Caused by tension in the neck and shoulders that travels upward, triggering pain in the head. Not as well defined as others but quite common, these headaches vary in duration and intensity.

INVESTIGATE IT
Often the result of injury, neck headaches may also be caused by stress, poor posture or muscle stiffness.

TREAT IT
Instead of OTCs, this type of headache pain may respond better to physical treatments, says Kern, including massage, acupuncture, exercise, relaxation and posture work.

TIP
Take headache medication as soon as you feel pain. Drugs need time to work, and headaches respond better during the early stages of an attack.

Need more info? Go to headachenetwork.ca

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